Individual
MRS. JENNIFER B CARLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1100 NOLAN TRACE, LEESVILLE, LA 71446
(337) 238-5180
(337) 238-4840
Mailing address
1100 NOLAN TRACE, LEESVILLE, LA 71446
(337) 238-5180
(337) 238-4840
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP05283
LA
363LA2200X
Adult Health Nurse Practitioner
AP05283
LA
363LF0000X
Family Nurse Practitioner
AP05283
LA
Other
Enumeration date
08/29/2007
Last updated
10/02/2014
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